• Journal of Nutrition and Health
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• v.25 no.7
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• pp.608-616
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• 1992

Using the hematofluiorometer normal values of the erythrocyte zinc protoporphyrin(ZPP) and ZPP/Heme ratio were measured in 312 males and 163 females aged from 6 month to 73 years old and compared with those of anemic persons. The mean$\pm$SD values of ZPP of normal Koreans were 28.5$\pm$6.4($\mu\textrm{g}$/dl) in males and 3.18$\pm$7.7 in females. the mean$\pm$SD of ZPP/Heme ratio were 49.5$\pm$12.3($\mu$mol/mol heme) in males and 62.0$\pm$15.8 in females. The difference in the mean ZPP and ZPP/Heme ratio values between male and female subjects were statistically signficant(p<0.0001) In male subjects the mean ZPP and ZPP/Heme ratio of the age groups less than 15 years old were higher than adult groups and the difference between age groups was significant(p<0.005 and p<0.0001 respecti-vely) The normal upper limit of the mean$\pm$2SD in normal male and female subjects were 41.3 and 47.2 for ZPP and 74.1 and 93.6 for ZPP/Heme ratio respectively. The mean values of ZPP and ZPP/Heme ratio measured in the anemic persons were higher than those of normal subjects and did not show any significant difference by the sex and age groups except in 6-14 years male groups. The test specificity(positivity) analyzed in the anemic persons by the cut-off values calculated from the normal data were 50.6% for ZPP and 73.0% for ZPP/Heme ratio. The correlation analysis between blood hemoglobin and erythrocyte ZPP or ZPP/Heme ratio in the total 801 normal and anemic subjects showed that there are very high logarithmic correlation between the hemoglobin levels and ZPP/Heme ratio (r=-0.8339) and high correla-tion between the hemoglobin levels and ZPP concentrations(r=-0.6372) These results suggested that the measurement of the erythrocyte ZPP and ZPP/Heme ratio with the hematofluorometer can be a usuful screening method for iron deficiency anermin because they provide a reliable immediate results with a small amount of sample and are relatively simple and inexpensive.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.40-45
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• 2011

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.